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General NPI Number Information
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NPI Number | 1033467600
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Entity Type | Organization
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Legal Business Name | THE MULTICULTURAL ADDICTION SERVICES, LLC
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 750 S ORANGE BLOSSOM TRL 220
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City | ORLANDO
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State | FL
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Zip | 32805-3118
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Country | US
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Telephone | 407-369-9482
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Fax | 407-385-8140
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Provider Business Mailing Address
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Address Line | 750 S ORANGE BLOSSOM TRL 220
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City | ORLANDO
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State | FL
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Zip | 32805-3118
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Country | US
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Telephone | 407-369-9482
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Fax | 407-385-8140
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. JANET LICIAGA
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Credential | CAP, ICADC
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Telephone | 407-369-9482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0948AD803001
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License Number State | FL
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